Embed Size (px)
Citation preview
102年台灣整形外科醫學會
In-situ Pedicle Lengthening of Anterolateral Thigh Flap黃昱豪 謝東穎 黃書鴻 李書欣 林幸道 賴春生 張
高評 高雄醫學大學附設中和紀念醫院 整形外科
2013.11.17(日 ) 15:10~15:20 p.m. at 成大
BACKGROUND
• Anterolateral thigh (ALT) flap:• Versatility• Low donor-site morbidity• Widespread application
Versatility of ALT flap…
Type IType I Type IIType II Type IIIType III Type IVType IV
Distally based ALT flap Distally based ALT flap
Descending Branch 57% - 100%Descending Branch 57% - 100%Oblique Branch 14% - 43%Oblique Branch 14% - 43%
Most commonMost common
Shorter PedicleShorter Pedicle
How
Is the Pedicle?
LONG
God bless you……
God bless you……
CASE REPORT
• Case profile:• 42 y/o, male• DM(-), HTN(-)• Smoking(+), Betel nut(+)
20120815 1st OP
• Rt mandible defect• Lt free ALT flap• Rt sup. thyroid a. + IJV
20120815 1st OP
• Post OP View
20130509 2nd OP
• Rt maxillary defect
Pre-op Angiography- Rt
Pre-op Angiography- Lt
Pre-OP Surgical Planning
Long pedicle!!
Long pedicle!!
20130509 2nd OP
20130509 2nd OP
20130509 2nd OP
• Still 2-team approach• Dividing after anastomosis• 7cm 18cm
20130509 2nd OP
DISCUSSION
• Methods of lengthening:• Vein graft• Vascular bundle bridge• Our innovation
Descending vascular bundle of LCFA
In our design…..many advantages
In-situ lengthen pedicle 2-team approach Physiologic restoration No vein graft No new wound No extra ischemic time
CONCLUSION
• An efficient, reproducible, successful way to perform in-situ lengthening pedicle of ALT flap.
Accepted in Jan. 2014… …Thanks… …
